Acromegaly is invariably caused by a GH secreting pituitary tumour and results in significant patient morbidity and premature cardiovascular mortality. Treatment options first and foremost should reverse the disabling symptoms (headache, sweating, tiredness, paraesthesia, arthralgia,snoring) and address the pituitary tumour itself, ideally with total excision and prevention of recurrence. The last 10 years has also seen an evidence base for the biochemical follow-up and "cure" of patients with Acromegaly, with a series of retrospective follow-up studies showing normalization of mortality rates if GH can be reduced to <5 mU/L.